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Chromoendoscopy versus narrow band imaging in UC: a prospective randomised controlled trial
Gut ( IF 24.5 ) Pub Date : 2017-07-11 , DOI: 10.1136/gutjnl-2016-313213
Raf Bisschops , Talat Bessissow , Joseph A Joseph , Filip Baert , Marc Ferrante , Vera Ballet , Hilde Willekens , Ingrid Demedts , Karel Geboes , Gert De Hertogh , Séverine Vermeire , Paul Rutgeerts , Gert Van Assche

Background Patients with long-standing UC have an increased risk for the development of colonic neoplastic lesions. Chromoendoscopy (CE) has been proven to enhance neoplasia detection while the role of virtual chromoendoscopy (VC) is still to be defined. Objective To compare the performance of CE to VC for the detection of neoplastic lesions in patients with long-standing UC. Design A multicentre prospective randomised controlled trial. 131 patients with long-standing UC were randomised between CE with methylene blue 0.1% (n=66) or VC with narrow band imaging (NBI) (n=65). Biopsies were taken from visible lesions and surrounding mucosa. No random biopsies were performed. The primary outcome was the difference in total number of neoplastic lesions detected in each group. Results There was no significant difference between NBI and CE for neoplasia detection. Mean number of neoplastic lesions per colonoscopy was 0.47 for CE and 0.32 for NBI (p=0.992). The neoplasia detection rate was not different between CE (21.2%) and NBI (21.5%) (OR 1.02 (95% CI 0.44 to 2.35, p=0.964). Biopsies from the surrounding mucosa yielded no diagnosis or dysplasia. The per lesion neoplasia detection was 17.4% for CE and 16.3% for NBI (OR 1.09 (95% CI 0.59 to 1.99, p=0.793). The total procedural time was on average 7 min shorter in the NBI group. Conclusion CE and NBI do not differ significantly for detection of colitis-associated neoplasia. Given the longer withdrawal time for CE and easier applicability, NBI may possibly replace classical CE. Trial registration number NCT01882205; Results.

中文翻译:

UC 中的色素内镜与窄带成像:一项前瞻性随机对照试验

背景 长期 UC 患者发生结肠肿瘤病变的风险增加。色素内镜 (CE) 已被证明可以增强肿瘤检测,而虚拟色素内镜 (VC) 的作用仍有待确定。目的 比较 CE 与 VC 在检测长期 UC 患者肿瘤病变方面的性能。设计 一项多中心前瞻性随机对照试验。131 名长期 UC 患者随机分为 CE 与亚甲蓝 0.1% (n=66) 或 VC 与窄带成像 (NBI) (n=65)。活检取自可见病变和周围粘膜。没有进行随机活检。主要结果是每组检测到的肿瘤病变总数的差异。结果 NBI 和 CE 在肿瘤检测方面没有显着差异。每次结肠镜检查的平均肿瘤病变数对于 CE 为 0.47,对于 NBI 为 0.32 (p=0.992)。CE (21.2%) 和 NBI (21.5%) 之间的瘤形成检出率没有差异(OR 1.02(95% CI 0.44 至 2.35,p=0.964)。来自周围粘膜的活检未发现诊断或异常增生。每个病变的瘤形成CE 的检测率为 17.4%,NBI 的检测率为 16.3%(OR 1.09(95% CI 0.59 至 1.99,p=0.793)。NBI 组的总手术时间平均缩短 7 分钟。结论 CE 和 NBI 没有显着差异用于检测结肠炎相关肿瘤。鉴于 CE 的停药时间更长且更易于适用,NBI 可能会取代经典 CE。试验注册号 NCT01882205;结果。每次结肠镜检查的平均肿瘤病变数对于 CE 为 0.47,对于 NBI 为 0.32 (p=0.992)。CE (21.2%) 和 NBI (21.5%) 之间的瘤形成检出率没有差异(OR 1.02(95% CI 0.44 至 2.35,p=0.964)。来自周围粘膜的活检未发现诊断或异常增生。每个病变的瘤形成CE 的检测率为 17.4%,NBI 的检测率为 16.3%(OR 1.09(95% CI 0.59 至 1.99,p=0.793)。NBI 组的总手术时间平均缩短了 7 分钟。结论 CE 和 NBI 没有显着差异用于检测结肠炎相关肿瘤。鉴于 CE 的停药时间更长且更易于适用,NBI 可能会取代经典 CE。试验注册号 NCT01882205;结果。每次结肠镜检查的平均肿瘤病变数对于 CE 为 0.47,对于 NBI 为 0.32 (p=0.992)。CE (21.2%) 和 NBI (21.5%) 之间的瘤形成检出率没有差异(OR 1.02(95% CI 0.44 至 2.35,p=0.964)。来自周围粘膜的活检未发现诊断或异常增生。每个病变的瘤形成CE 的检测率为 17.4%,NBI 的检测率为 16.3%(OR 1.09(95% CI 0.59 至 1.99,p=0.793)。NBI 组的总手术时间平均缩短了 7 分钟。结论 CE 和 NBI 没有显着差异用于检测结肠炎相关肿瘤。鉴于 CE 的停药时间更长且更易于适用,NBI 可能会取代经典 CE。试验注册号 NCT01882205;结果。结论 CE 和 NBI 在检测结肠炎相关肿瘤方面没有显着差异。鉴于 CE 的退出时间更长且更易于适用,NBI 可能会取代传统 CE。试验注册号NCT01882205;结果。结论 CE 和 NBI 在检测结肠炎相关肿瘤方面没有显着差异。鉴于 CE 的退出时间更长且更易于适用,NBI 可能会取代传统 CE。试验注册号NCT01882205;结果。
更新日期:2017-07-11
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